Developments in the fight against COVID-19, the novel coronavirus that emerged from China and is now present across the globe, are occurring on a daily, oftentimes, hourly basis.
 
To consolidate information for the public and its members, last week MHA created a COVID-19 webpage, and delivered the first COVID-19 Update newsletter to its membership.
 
Last Thursday, CMS issued two calls to action to 1) ensure that all healthcare providers are implementing their infection control procedures, and 2) ordering all State Survey Agencies and accrediting organizations to focus their facility inspections exclusively on issues related to infection control and other serious health and safety threats, beginning with nursing homes and hospitals.
 
Last Wednesday, the Massachusetts Legislature’s Joint Committee on Public Health held a hearing on the state’s response to COVID-19. Among those who testified were Paul Biddinger, M.D., from Massachusetts General Hospital; Michael Mina, M.D., from Brigham and Women’s Hospital; and Davidson Hamer, M.D., from Boston University Schools of Public Health and Medicine. Administration officials and representatives of local public health agencies also testified.
 
Legislators learned that hospital emergency preparedness teams have been prepping for such events, especially since the Ebola scare of 2014. Local public health experts called for an enhanced communication campaign in multiple languages to educate the public on the issue, while medical experts and epidemiologists iterated that the hope for a quick vaccine to prevent COVID-19 is misplaced; 12 to 18 months is the most optimistic timeline for a vaccine, but 18 to 24 months is more realistic. (It’s also possible that a vaccine will simply not work.)
 
Another item discussed at the Wednesday hearing is the possibility that accustomed “social norms” may be eliminated because of the virus. A quick hug between friends or a friendly handshake between those meeting for the first time may be replaced by a nod, a bow, or an elbow bump going forward.
 
The best place to keep abreast of rapidly developing news is through the DPH or CDC websites. Both are updating their sites several times a day. MHA’s site is also refreshed regularly.

On March 6, the president signed an $8.3 billion funding bill for COVID-19-related activities for the United States and abroad. The House and Senate had quickly passed the bill on Wednesday and Thursday.
 
The package provides an additional $7.7 billion in discretionary funding and authorizes more than $400 million in mandatory spending by removing certain restrictions on Medicare reimbursement for telemedicine. The bill appropriates $2.2 billion for the Centers for Disease Control and Prevention (CDC). Of the CDC funds, $1 billion will go to state and local preparedness and response grant programs and will reach the entities within 30 days. The CDC funds will also be used for global health security and the Infectious Disease Rapid Response Fund.
 
The bill appropriates $3.1 billion to the Office of the Secretary for Preparedness and Response. These funds will be used to procure medical supplies for the Strategic National Stockpile; to research and develop vaccines, therapeutics, and diagnostic testing, and to improve access to such products; and to support community health centers. The bill also supports the National Institutes of Health in developing vaccines, therapeutics, and diagnostics, as well as the Food and Drug Administration to monitor and mitigate product shortages, among other things. Additionally, the bill appropriates $1.25 billion for the Department of State and USAID for international issues related to the coronavirus. Finally, the bill waives telehealth requirements to help ensure Medicare beneficiaries can receive care at home rather than placing themselves and others at risk while attempting to seek care.

An accomplished group of Massachusetts hospital leaders is featured in MHA’s new “Voices in Healthcare” video blog released today. Joseph White; Kevin Churchwell, M.D.; Philip Cormier; Kim Hollon; Mark Keroack, M.D.; and Christine Schuster, R.N. lead various types of hospitals – community, specialty, academic medical centers – from across the commonwealth.
  
The six senior executives offer their thoughts and insights on the current status and future of healthcare in Massachusetts, the changing nature of healthcare leadership, as well as what challenges and inspires them in their work. Click here to view the vlog.
  
White is president & CEO of Circle Health and Lowell General Hospital, and chairs MHA’s board of trustees. Churchwell is president & COO of Boston Children’s Hospital; Cormier is president of Beverly and Addison Gilbert Hospitals, part of Beth Israel Lahey Health; Hollon is president & CEO of Signature Healthcare; Keroack is president & CEO of Baystate Health; and Schuster is president & CEO of Emerson Hospital.

With a desire to help students with disabilities living within its 20-town service area make a successful transition to productive adult life, Milford Regional Medical Center adopted Project SEARCH, a national transitional program to teach valuable life and job skills.
 
Designed for students with intellectual and developmental disabilities entering their last year of high school, Project SEARCH provides internship placement based on the student’s experiences, strengths, and skills, with the end goal being competitive employment within the community. All students need to be eligible for the Massachusetts Rehabilitation Commission or other vocational rehabilitation services to participate.
 
First launched at an Ohio hospital, the program has been replicated across the country, and Milford Regional Medical Center, in partnership with Milford Public Schools, was the first hospital in Massachusetts to adopt Project SEARCH.
 
In an internship-like setting, the program participants work with a teacher and an on-site job coach. Students rotate through three, 11-week internships in hospital departments, which have included sterile processing, environmental services, stock room, food services, pharmacy, and facilities. In the eight years since its implementation, Milford Regional has not only sustained the program, but has hired five former Project SEARCH participants.
 
“It is great to see the growth and development of the interns as they master job skills and become independent in the hospital setting,” says Director of Volunteer Services Elaine Willey, business liaison for the program at Milford Regional. “They become part of our team.”
 
According to the Attorney General’s Office, Massachusetts hospitals provided $641 million in community benefits for residents of Massachusetts in Fiscal Year 2018. These hospital community benefits programs – provided at no cost to those being served – are not reimbursed by state or federal governments, by any health insurance company, or through any public subsidy. View community benefit stories from across Massachusetts in this MHA Commitment to Community publication.

Hospitals officials from around the state last Wednesday participated in an MHA-sponsored webinar and forum on the federal government’s public charge rule. Representatives from Health Care For All and Health Law Advocates led the discussion. Since the proposed new rule was unveiled last summer (it became effective in February) the healthcare community has been concerned that immigrants, whatever their status, will simply forego applying for healthcare programs for which they are eligible rather than take any risk of having these benefits later used against them in an application for an immigration status determination.
 
At last week’s discussion, HealthCare For All outlined the following guiding principles for immigrants and their caregivers: 1) everyone in Massachusetts can access some health services regardless of immigration status; 2) it is safe to see a doctor in a health clinic or go to the hospital, even if you have a medical emergency; 3) you can access quality and affordable medical services at a community health center in your local community and they may have staff who speak your language; 4) if you cannot afford your medical bills, there may be help available to you; 5) your doctor, health center, and hospital cannot give your personal information (including information about your immigration status) to the government unless you agree to share that information or there is a judicial order; and 6) it is safe to apply for MassHealth, the Health Connector, or Health Safety Net. Those programs do not share personal information, including your immigration status, with immigration enforcement authorities such as ICE.

Criticism over a proposed CMS rule relating to Medicaid funding continues to grow as last week a letter began to circulate in the U.S. Senate asking CMS Administrator Seema Verma to withdraw the proposal. Massachusetts Senators Elizabeth Warren and Ed Markey signed on to the letter.
 
The Medicaid Fiscal Accountability Regulation (MFAR) would significantly alter the ways that states have funded their Medicaid programs, including limiting the use of intergovernmental transfers and provider taxes to finance the state share of Medicaid costs, severely reducing physician supplemental payments, and establishing burdensome provider-level reporting requirements. An American Hospital Association study estimates the rule could reduce Medicaid funding by up to $49 billion annually, jeopardizing care for millions.
 
A bipartisan group of governors from across the U.S., including the commonwealth’s Charlie Baker, are opposing the proposed rule. MHA’s President & CEO Steve Walsh wrote Verma in January saying MFAR threatens “access for low-income citizens, the ability of healthcare providers to serve their patients, innovation within the Medicaid program, and the overall economy.”
 
The Senate letter notes the widespread opposition and adds, “To make matters worse, in issuing its proposed rule, the Administration failed to conduct a full fiscal impact analysis stating that the ‘fiscal impact on the Medicaid program from the implementation of the policies in the proposed rule is unknown.’ … Such blatant administrative malpractice is completely unacceptable and one more item on a long list of reasons why the proposed rule must not move forward.”

The U.S. Supreme Court said last Monday that it would take up a case involving the constitutionality of the Affordable Care Act. The court decided earlier this year not to hear the case on an “expedited schedule” – meaning before June 2020. Monday’s decision means the court will take up the issue during its fall 2020 term but won’t issue a decision until after the 2020 elections.
 
The case, Texas v. U.S., was brought by the Trump Administration and Republican Attorneys General who view the ACA’s individual mandate as unconstitutional and that, therefore, the entire act should be overturned. Democratic AG’s as well as a number of state hospital associations (including MHA) and others, filed briefs defending the ACA and urging the Supreme Court to take up the case as opposed to having lower courts resolve the issue which would inevitably lead to an appeal to the Supreme Court in the future. While the Trump Administration has argued vociferously against the ACA, it has not yet presented an alternative to it.

Between March 12 and 20, households across the U.S. will begin receiving official Census Bureau mail with detailed information on how to respond to the 2020 census online, by phone, or by mail. A complete count of everyone living in the commonwealth is critically important for many reasons, including a stable healthcare system. Census data determines the amount of representatives each state is allotted, informs the shape of re-districting of Congressional seats, and dictates how more than $675 billion in federal funds – much of which is for healthcare – is distributed among states, counties, and communities. Earlier this year, MHA distributed a census toolkit to hospitals to assist them in fulfilling the complete count goal.

Healthcare Project Management

Wednesday, May 20; 8:30 a.m. – 3 p.m.
MHA Conference Center, Burlington, Mass.

Healthcare organizations are facing major challenges with changes in payment systems and increased emphasis on quality, patient safety, and patient/employee experience/satisfaction. Faced with these challenges, organizations are launching major performance improvement projects, including: (a) revenue cycle improvements (billing and collections); (b) implementation of electronic medical records and information systems; (c) supply chain cost reductions; (d) operations improvement including patient flow and resource utilization; (e) quality and patient safety improvements; and (f) patient/employee experience/satisfaction improvements. This one-day session provides participants with an overview of project management and an opportunity to practice some of the skills needed to successfully manage a project. In addition, participants will explore project management through the lens of audiences affected by their work and learn how to engage and sustain the involvement and participation from project sponsors and key stakeholders. Click here to learn more about this conference, including registration details.